Cortesi N, Zanni C, Gotuzzo L, Barberini G, Marchetti A, Piccagli I
J Chir (Paris). 1975 Jul-Aug;110(1-2):71-6.
The authors report a case of acute necrotising enteritis occurring on the 7th day after total hysterectomy with bilateral removal of the adnexa for fibroids in a 45 year-old woman. This is the first case in the literature to occur after hysterectomy. The clinical picture included the onset of intestinal obstruction with severe general toxic manifestations. The diagnosis was made at operation and, in spite of intestinal resection, the patient died on the 6th day, with liver and renal failure, anuria and irreversible collapse. The blood and stool cultures were negative, but the histological appearance of the lesions, without any apparent suppuration, were in favour of a vascular etiology. Necrosis of the mucosa and inflammatory oedema of the sub-mucosa, were accompanied by vascular changes suggesting thrombosis and congestion.
作者报告了一例急性坏死性小肠炎病例,该病例发生在一名45岁女性因子宫肌瘤行全子宫切除术并双侧附件切除术后第7天。这是文献中首例子宫切除术后发生的此类病例。临床表现为肠梗阻发作并伴有严重的全身中毒症状。手术时做出了诊断,尽管进行了肠切除,但患者在第6天死于肝肾功能衰竭、无尿和不可逆的休克。血液和粪便培养均为阴性,但病变的组织学表现虽无明显化脓,却支持血管源性病因。黏膜坏死和黏膜下炎性水肿伴有提示血栓形成和充血的血管变化。